JP5847367B1 - Endoscope and holding mechanism for guide member for endoscope - Google Patents

Abstract

The holding mechanism 500 includes holding units 501 and 503. The holding unit 501 holds a part 301 a exposed to the outside of the endoscope 10. The holding unit 503 is disposed at a position different from the holding unit 501. The holding unit 503 holds another part 301 b exposed to the outside of the endoscope 10 in a direction different from the direction of the holding unit 501.

Description

  The present invention relates to a holding mechanism for a guide member for holding a guide member for an endoscope for guiding a treatment tool protruding from an opening provided in an insertion portion of the endoscope to a subject, and the holding mechanism. The present invention relates to an endoscope having a mechanism.

Generally, when a treatment tool treats a subject such as a bile duct, a side-view type endoscope and a guide member that guides the treatment tool to the subject are used.
In this case, the treatment instrument has a cylindrical member that is disposed at the distal end of the treatment instrument and through which the guide member can be inserted. The tubular member can slide the guide member so that the guide member passes through the tubular member. By this sliding, the cylindrical member functions as a monorail portion, and the treatment instrument can move along the guide member.
The guide member is formed by a thin linear member, for example.

The guide member is inserted into the treatment instrument insertion channel communicating with the treatment instrument insertion port through the treatment instrument insertion port from the forceps plug disposed in the grip portion of the endoscope. And the front-end | tip part of a guide member penetrates a treatment tool penetration channel, and protrudes from the front-end | tip opening part arrange | positioned at the front-end | tip part of the insertion part of an endoscope. In the side-view type endoscope, the tip opening is disposed on the side surface of the tip. For this reason, the front-end | tip part of a guide member protrudes to the side of the front-end | tip part of an insertion part. Then, the distal end portion of the guide member reaches the subject. Note that the proximal end portion of the guide member is exposed to the outside of the endoscope from the treatment instrument insertion port.
The treatment instrument moves along the guide member by the tubular member so that the guide member penetrates the tubular member. At this time, the treatment instrument is guided by the guide member and is inserted into the treatment instrument insertion channel from the forceps plug portion via the treatment instrument insertion port. The treatment instrument is guided by the guide member, passes through the treatment instrument insertion channel, protrudes laterally from the distal end opening, and reaches the subject.
Thus, the treatment tool is guided to the subject by the guide member.

Such a guide member is disclosed in Patent Document 1 and Patent Document 2, for example.
In Patent Literature 1 and Patent Literature 2, the guide member is fixed and the proximal end portion of the guide member is held by a holding member separate from the endoscope so that the guide member is prevented from being displaced. . The holding member is attached to the treatment instrument insertion port so as to be detachable from the endoscope.

Special table 2008-529723 gazette JP 2003-116777 A

  In Patent Document 1 and Patent Document 2, since the holding member is separate from the endoscope, it takes time and effort to attach the holding member to the endoscope. Since the holding member is separate from the endoscope, the cost is high. When the treatment instrument advances and retreats along the axial direction of the treatment instrument, there is a risk that the guide member may be displaced due to advance and retreat movement.

  For this reason, it is required to reduce the mounting effort, to be inexpensive, and to prevent the guide member from shifting.

  The present invention has been made in view of these circumstances, and a holding mechanism for a guide member for an endoscope that suppresses the mounting effort, is inexpensive, and prevents the guide member from being displaced, and the holding mechanism. It is an object to provide an endoscope having the following.

One aspect of a holding mechanism for a guide member for an endoscope according to the present invention is inserted into the lumen through an insertion portion of an endoscope that is inserted into the lumen, and is disposed in the insertion portion. A holding mechanism for an endoscope guide member that holds a guide member that projects from an opening and guides a treatment instrument, and is an operation that operates the endoscope and is connected to a proximal end portion of the insertion portion A first portion of the guide member that is exposed from the endoscope on the proximal end side of the guide member in a state where the distal end portion of the guide member protrudes from the opening. A holding portion and a position different from the first holding portion in the operation portion, and a position different from a portion held by the first holding portion on the proximal end side of the guide member; and The guide member is held in an orientation different from the orientation of the first holding portion. That a second holding part, comprising a said at least one of the first holding portion and the second holding portion, that portion of the exterior portion of the operation unit recessed, said guide member A groove is formed to engage a part of the base end portion .

FIG. 1A is a schematic perspective view of a side-view type endoscope according to the first embodiment of the present invention. FIG. 1B is a top view of the hard tip portion. FIG. 2A is a schematic diagram of a holding mechanism for an endoscope guide member according to the first embodiment. FIG. 2B is a longitudinal sectional view showing an example of the configuration of the groove. FIG. 2C is a cross-sectional view illustrating an example of the configuration of the groove. FIG. 3A is a diagram illustrating that a contrast tube is inserted into a bile duct. FIG. 3B is a diagram illustrating that the guide member is inserted into the bile duct. FIG. 3C is a diagram illustrating that the treatment tool is inserted into the bile duct by the guide of the guide member. FIG. 3D is a perspective view of a cylindrical member through which the guide member is inserted. FIG. 4A is a schematic diagram of a holding mechanism in Modification 1 of the first embodiment. FIG. 4B is a top view of the holding portion including the forceps plug portion shown in FIG. 4A. FIG. 5A is a schematic perspective view of a holding mechanism according to the second embodiment. FIG. 5B is a side view of the periphery of the holding unit. FIG. 5C is a perspective view of the periphery of the holding unit. FIG. 6 is a side view of the vicinity of the holding portion in the holding mechanism according to the first modification of the second embodiment. FIG. 7 is a side view of the periphery of the holding unit in the holding mechanism according to the second modification of the second embodiment.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

[First Embodiment]
[Constitution]
The first embodiment will be described with reference to FIGS. 1A, 1B, 2A, 2B, 2C, 3A, 3B, 3C, and 3D. Note that, for example, in FIG. 1A, illustration of a holding mechanism 500 for an endoscope guide member is omitted, and in some drawings, illustration of some members is omitted for clarity of illustration. Yes.

[Endoscope 10]
An endoscope 10 as shown in FIG. 1A is, for example, a side-view type endoscope.
As shown in FIG. 1A, an endoscope 10 is connected to a hollow elongated insertion portion 20 to be inserted into a lumen such as a body cavity of a patient, and a proximal end portion of the insertion portion 20 to operate the endoscope 10. And an operation unit 30 to be operated.

[Insertion section 20]
As shown in FIG. 1A, the insertion portion 20 includes a distal end hard portion 21, a bending portion 23, and a flexible tube portion 25 from the distal end portion side of the insertion portion 20 toward the proximal end portion side of the insertion portion 20. Have. The proximal end portion of the distal rigid portion 21 is connected to the distal end portion of the bending portion 23, and the proximal end portion of the bending portion 23 is connected to the distal end portion of the flexible tube portion 25.
The distal end hard portion 21 is the distal end portion of the insertion portion 20 and is hard and does not bend. The configuration of the distal end hard portion 21 will be described later.
The bending portion 23 is bent in a desired direction, for example, up, down, left, and right, by an operation of a bending operation unit 37 described later. When the bending portion 23 is bent, the position and orientation of the distal end hard portion 21 are changed. Then, illumination light (not shown) is illuminated on the observation object, and the observation object is captured in the observation field. The observation object is, for example, an affected part or a lesion part in a subject (for example, a body cavity).
The flexible tube portion 25 has desired flexibility. Therefore, the flexible tube portion 25 is bent by an external force. The flexible tube portion 25 is a tubular member that extends from a main body portion 31 described later in the operation portion 30.

[Operation unit 30]
As shown in FIG. 1A, the operation unit 30 is connected to a main body part 31 from which the flexible tube part 25 extends and a base end part of the main body part 31 and is held by an operator who operates the endoscope 10. And a universal cord 41 connected to the grip portion 33.

[Grip part 33]
As shown in FIG. 1A, the gripping part 33 includes a treatment instrument insertion part 35, a bending operation part 37 for bending the bending part 23, and a switch part 39. The treatment instrument insertion portion 35 is disposed on the distal end side of the grip portion 33, and the bending operation portion 37 and the switch portion 39 are disposed on the proximal end portion side of the grip portion 33.

[Treatment instrument insertion part 35]
As shown in FIG. 1A, the treatment instrument insertion portion 35 is branched with respect to the grasping portion 33. For this reason, the central axis direction of the treatment instrument insertion portion 35 is inclined with respect to the central axis direction of the grasping portion 33.
As shown in FIG. 1A, the treatment instrument insertion portion 35 is disposed at the end of the treatment instrument insertion portion 35, and is disposed so that a guide member 300 and a treatment instrument 400 described later are inserted into the endoscope 10. It has a treatment instrument insertion port 35a.

The treatment instrument insertion port 35a is connected to a proximal end portion of a treatment instrument insertion channel (not shown). The treatment instrument insertion channel is disposed inside the insertion portion 20, and is disposed from the flexible tube portion 25 through the bending portion 23 to the distal end hard portion 21. The distal end portion of the treatment instrument insertion channel communicates with a distal end opening portion 35c (see FIG. 1B) disposed in the distal end rigid portion 21. The treatment instrument insertion port 35a is an insertion slot for inserting the guide member 300 and the treatment instrument 400 into the treatment instrument insertion channel.
As shown in FIG. 1A, the central axis of the treatment instrument insertion port portion 35 a is disposed coaxially with the central axis of the treatment instrument insertion portion 35, and is therefore inclined with respect to the central axis of the grasping portion 33. . Further, the central axis direction is inclined with respect to the central axis direction of the grip portion 33.

  As shown in FIG. 2A, the treatment instrument insertion portion 35 further includes a cylindrical forceps plug portion 36 disposed in the treatment instrument insertion portion 35. The forceps plug portion 36 is made of a resin such as rubber, for example. The central axis of the forceps plug portion 36 is disposed coaxially with the central axis of the treatment instrument insertion port portion 35a. For this reason, the forceps plug portion 36 is inclined with respect to the grip portion 33. When the forceps plug portion 36 is disposed in the treatment instrument insertion portion 35, the forceps plug portion 36 communicates with the treatment instrument insertion channel via the treatment instrument insertion port 35a.

  The guide member 300 shown in FIG. 2A and the treatment instrument 400 shown in FIG. 3C are inserted into the treatment instrument insertion channel from the forceps plug portion 36 via the treatment instrument insertion port portion 35a and pushed to the distal end hard portion 21 side. As shown in FIGS. 2A, 3B, and 3C, the guide member 300 and the treatment instrument 400 protrude from the distal end opening 35c.

[Bending operation unit 37]
As shown in FIG. 1A, the bending operation section 37 includes a left / right bending operation knob 37a for bending the bending section 23 left and right, a vertical bending operation knob 37b for bending the bending section 23 up and down, and a curved bending section 23. And a fixing knob 37c for fixing the position.

[Switch section 39]
As shown in FIG. 1A, the switch unit 39 includes a suction switch 39a, an air / water supply switch 39b, and various switches 39c for endoscopic photography. The suction switch 39a, the air / water supply switch 39b, and the various switches 39c are operated by the operator's hand when the grip portion 33 is gripped by the operator.
The suction switch 39a is operated when the endoscope 10 sucks mucus, fluid, or the like through the treatment instrument insertion channel that also serves as a suction channel from the distal end opening 35c that also serves as a suction opening.
The air supply / water supply switch 39b is used to supply fluid from an air supply tube (not shown) and an air supply / water supply tube (not shown) and a water supply tube in order to secure an observation field of view of the imaging unit 70 at the distal end hard portion 21. And when air is supplied from the air / water supply tube. The fluid includes water and gas.
The air supply tube, the water supply tube, and the air / water supply tube are disposed from the insertion portion 20 to the universal cord 41 through the main body portion 31 and the grip portion 33 in the endoscope 10. .

[Universal code 41]
As shown in FIG. 1A, the universal cord 41 extends from the side surface of the grip portion 33. The universal cord 41 has a connection connector 41 a that is detachable from the control device 14. The control device 14 controls the endoscope 10. The control device 14 includes an image processing unit that processes an image captured by the imaging unit. The control device 14 is connected to a display unit 16 that is a display unit that displays an image captured by the imaging unit.

[Configuration of the hard tip portion 21]
As shown in FIG. 1B, the distal end hard portion 21 has a main body portion 211 and a cap portion 213.

  The main body 211 is made of a metal such as stainless steel, for example. The base end portion of the main body portion 211 is connected to the distal end portion of the bending portion 23. The main body 211 has a cylindrical shape, for example. And as shown in FIG. 1B, a part of outer peripheral surface of the main-body part 211 is planarly formed by notching a part of the main-body part 211. As shown in FIG. As described above, the main body 211 has the flat surface portion 211a and the wall surface portion 211b orthogonal to the flat surface portion 211a.

  As shown in FIG. 1B, the cap part 213 covers the main body part 211 except for the flat surface part 211a and the wall surface part 211b. The cap part 213 is watertightly bonded to the main body part 211. The cap part 213 is fixed with respect to the main body part 211. The cap part 213 has electrical insulation.

[Main unit 211]
As shown in FIG. 1B, the main body 211 is mounted with a tip opening 35c, an air / water supply nozzle 61, an imaging unit 70, and an illumination unit 80.

[End opening 35c]
As shown in FIG. 1B, the tip opening 35c is recessed with respect to the flat portion 211a. That is, the tip opening 35 c opens toward the side of the main body 211. The distal end opening 35c houses a treatment instrument raising base 51 that can be remotely rocked in accordance with the raising operation on the hand side. The treatment instrument elevator 51 is connected to an elevator operating unit (not shown) via an elevator operation wire (not shown) that passes through the insertion unit 20. The elevator base operation unit is disposed, for example, on the grip 33 that indicates the proximal side. When the raising base operation unit pushes and pulls the raising operation wire, the treatment instrument raising base 51 freely rotates with respect to the main body 211 about a support shaft (not shown). For example, the treatment instrument raising base 51 is inverted with respect to the flat surface portion 211a of the main body portion 211 and protrudes from the storage position stored in the main body portion 211 and the flat surface portion 211a of the main body portion 211, that is, the distal end opening portion 35c. Swing between the raised position and the raised position. The treatment instrument raising base 51 is swung according to the raising operation, and guides the treatment instrument 400 to protrude from the distal end opening 35 c to the side of the main body 211. The treatment instrument raising base 51 may include a treatment instrument guide groove 53 that guides the treatment instrument 400 from the main body 211 to the outside. The treatment instrument guide groove 53 is disposed at the center of the treatment instrument elevator base 51 and is further disposed along the longitudinal axis direction of the treatment instrument elevator base 51.

[Air / water nozzle 61]
As shown in FIG. 1B, the air / water supply nozzle 61 is disposed on the wall surface portion 211 b of the main body portion 211. The air / water supply nozzle 61 is collinear with the observation window 71 of the imaging unit 70 in the axial direction of the insertion unit 20 so as to supply air / water to the observation window 71 of the imaging unit 70, for example. It is arranged. The air / water supply nozzle 61 including the wall surface portion 211b is disposed closer to the proximal end portion of the main body portion 211 than the observation window portion 71. The air / water supply nozzle 61 is connected to the air supply tube and the water supply tube via an air / water supply tube (not shown) that is inserted through the insertion portion 20. By operating the air / water supply switch 39b, the air / water supply nozzle 61 supplies air / water to the observation window 71.

[Imaging unit 70]
As shown in FIG. 1B, the imaging unit 70 has an observation window 71, a prism unit (not shown), and an imaging unit (not shown).

[Observation window 71]
As shown in FIG. 1B, the reflected light reflected from the observation object is incident on the observation window portion 71 in the side-viewing observation. For this reason, the observation window part 71 is arrange | positioned in the surrounding surface of the main-body part 211, for example, the plane part 211a, and is arrange | positioned on the same plane as the plane part 211a. That is, the imaging unit 70 is built in the main body 211 so that the observation window 71 is disposed on the flat surface 211a. The observation window portion 71 is exposed from the cap portion 213. The central axis of the observation window portion 71 is disposed orthogonal to the central axis of the main body portion 211.

[Prism part]
A prism unit (not shown) reflects the reflected light that has passed through the observation window 71 to change the progress of the reflected light. The prism portion is disposed inside the main body portion 211 so that the central axis of the prism portion is disposed substantially coaxially with the central axis of the observation window portion 71. The prism portion is disposed inside the main body 211 so as to face the observation window portion 71 in the orthogonal direction.

[Imaging part]
An imaging unit (not shown) is disposed adjacent to the prism unit in the axial direction of the insertion unit 20. That is, the imaging unit is arranged on the substantially same straight line as the prism unit in the axial direction of the insertion unit 20. The imaging unit is disposed along the axial direction of the insertion unit 20 together with the prism unit. Such an imaging unit is disposed inside the main body 211 so as to face the prism unit.
The imaging unit includes an objective optical system (lens system) (not shown) having an objective lens group having a predetermined image surface distortion, an imaging element (not shown) such as a CCD disposed at an imaging position of the objective optical system, A connection circuit board that does not. The objective optical system (lens system), the image sensor, and the connection circuit board are integrated.
An imaging cable (not shown) such as a signal line is connected to the connection circuit board. The imaging cable is inserted to the connection connector 41a through the bending portion 23, the flexible tube portion 25, the operation portion 30, and the universal cord 41. When the connection connector 41 a is connected to the control device 14, the imaging cable is connected to the control device 14, and the observation object imaged by the imaging unit 70 is displayed on the display unit 16.
In the objective optical system, at least a part of the lens may be movable along the longitudinal axis C direction. Thereby, the image sensor can capture an image of the observation object in a state where the focus of the image of the observation object is connected on the image sensor.
Instead of the image sensor, the tip of an image guide fiber (not shown) may be fixed, and the endoscope is not limited to an electronic scope but may be a fiber scope.

[Lighting unit 80]
As shown in FIG. 1B, the illumination unit 80 includes an illumination window portion 81, an illumination portion 83, and an illumination cable (not shown) connected to the illumination portion 83. The illumination unit 80 is disposed as a separate body from the imaging unit 70.

[Lighting window part 81]
As shown in FIG. 1B, the illumination window portion 81 transmits illumination light irradiated toward the observation object in the side-viewing observation. For this reason, the illumination window part 81 is arrange | positioned by the surrounding surface of the main-body part 211, for example, the plane part 211a, and is arrange | positioned on the same plane as the plane part 211a. That is, the illumination unit 80 is built in the main body 211 such that the illumination window 81 is disposed on the flat portion 211a. The illumination window part 81 is exposed from the cap part 213. The illumination window portion 81 is disposed adjacent to the observation window portion 71 in the axial direction of the insertion portion 20. That is, the illumination window portion 81 is arranged on the same straight line as the observation window portion 71 in the axial direction of the insertion portion 20. The illumination window portion 81 is disposed, for example, closer to the distal end portion of the main body 211 than the observation window portion 71. The central axis of the illumination window 81 is arranged along the orthogonal direction.

[Lighting part 83]
The illumination unit 83 emits illumination light such as white light, for example, toward the upper side which is a side. The illumination unit 83 includes, for example, an illumination light emitting end such as a light guide that guides illumination light emitted from a light source, or a light emitting element such as an LED. For example, two illumination units 83 are provided.
As shown in FIG. 1B, the illumination unit 83 is arranged inside the main body 211 so that the central axis of the illumination unit 83 is arranged substantially coaxially with the central axis of the illumination window 81. The illumination unit 83 is disposed below the illumination window unit 81. The illumination unit 83 is disposed inside the main body 211 so as to face the illumination window 81 in the orthogonal direction.

[Lighting cable]
An illumination cable (not shown) is provided for each illumination unit 83. The illumination cable has a longitudinal axis that faces the planar direction of the upper surface portion 85a. The longitudinal axis is disposed in parallel to the axial direction of the insertion portion 20. The illumination cable is disposed along the axial direction of the insertion portion 20 and is disposed below the illumination portion 83 in an orthogonal direction orthogonal to the axial direction of the insertion portion 20. The illumination cable is inserted into the connection connector 41a through the bending portion 23, the flexible tube portion 25, the operation portion 30, and the universal cord 41. When the connection connector 41a is connected to the control device 14, the illumination cable is connected to the control device 14, and the power from which the illumination unit 83 emits illumination light is supplied to the illumination cable. The lighting cable supplies power to the lighting unit 83.

[Guide member 300 for endoscope 10, treatment tool 400, and holding mechanism 500 for guide member 300]
As shown in FIGS. 2A, 3A, 3B, 3C, and 3D, the endoscope 10 includes a guide member 300 for the endoscope 10 and a treatment instrument 400 that are separate from the endoscope 10. used. The endoscope 10 is inserted into the treatment instrument insertion channel inside the endoscope 10 from the forceps plug portion 36 (treatment instrument insertion port 35a) before the treatment instrument 400, and protrudes from the distal end opening 35c. And a holding mechanism 500 that holds the guide member 300 that guides the treatment instrument 400 to the subject.

[Guide member 300]
As shown in FIG. 2A and as described above, the guide member 300 is inserted into the treatment instrument insertion channel from the forceps plug portion 36 via the treatment instrument insertion port 35a. The distal end portion of the guide member 300 is inserted through the treatment instrument insertion channel and protrudes from the distal end opening portion 35 c disposed on the side surface of the distal end portion of the insertion portion 20. Since the distal end opening portion 35 c is disposed on the side surface, the distal end portion of the guide member 300 protrudes to the side of the distal end portion of the insertion portion 20. The distal end portion of the guide member 300 reaches the subject. Thus, the guide member 300 is inserted into the lumen through the insertion portion 20 of the endoscope 10 that is inserted into the lumen. The guide member 300 protrudes from the distal end opening 35 c of the insertion portion 20 and guides the treatment instrument 400. Note that the base end portion 301 of the guide member 300 is exposed to the outside of the endoscope 10 from the forceps plug portion 36 in a state where the distal end portion of the guide member 300 protrudes to the outside from the distal end opening portion 35c.

  The guide member 300 is inserted into the treatment instrument insertion channel from the forceps plug section 36 before the treatment instrument 400 is inserted into the treatment instrument insertion channel from the forceps plug section 36. Although details will be described later, the guide member 300 is configured so that the treatment tool 400 is inserted into the treatment instrument insertion channel in a state where the guide member 300 is inserted into the treatment instrument insertion channel and the distal end portion of the guide member 300 protrudes to the outside from the distal end opening 35c. To guide.

  Such a guide member 300 is formed of, for example, a thin linear member. The linear member has, for example, a stainless steel wire. The linear member may have a nickel titanium wire, for example. The surface of the nickel titanium wire is coated with, for example, a fluororesin.

[Treatment tool 400]
As shown in FIG. 3C, the treatment tool 400 is used to treat a subject such as the bile duct 101, for example. Such a treatment instrument 400 includes, for example, an endoscopic sincterotomy (hereinafter referred to as EST) knife. The treatment tool 400 is formed of, for example, a thin linear member.

As illustrated in FIG. 3D, the treatment tool 400 is used together with the tubular member 401. The tubular member 401 functions as, for example, a multi-lumen, and has an insertion port portion 401a through which the guide member 300 can be inserted, and an engagement port portion with which, for example, the distal end portion of the treatment instrument 400 is engaged. The cylindrical member 401 is thicker than holding parts 501 and 503 described later. The tubular member 401 can slide the guide member 300 so that the guide member 300 is inserted through the insertion opening 401a. By this sliding, the tubular member 401 functions as a monorail portion, and the treatment tool 400 can move along the guide member 300. At this time, the treatment instrument 400 is guided by the guide member 300 and inserted into the treatment instrument insertion channel from the forceps plug portion 36 via the treatment instrument insertion port 35a. The treatment instrument 400 is guided by the guide member 300, passes through the treatment instrument insertion channel, protrudes laterally from the distal end opening 35c, and reaches the subject.
As described above, the treatment instrument 400 is guided to the subject by the guide member 300.

[Holding mechanism 500]
In general, the treatment tool 400 is operated so that the treatment tool 400 advances and retreats along the axial direction of the treatment tool 400 by the operation of the right hand of the surgeon while the grasping portion 33 is grasped by the left hand of the surgeon. Is done. For this reason, the holding mechanism 500 can hold or release the proximal end portion 301 of the guide member 300 by the operation of the operator's right hand in a state where the holding portion 33 is held by the operator's left hand. Further, it is disposed in the operation unit 30. In other words, in the holding mechanism 500, the base end portion 301 of the guide member 300 is attached to the grasping portion 33 via the holding mechanism 500 by the operation of the operator's right hand while the grasping portion 33 is grasped by the operator's left hand. It is arranged in the operation unit 30 so as to be possible or removable. As described above, the holding mechanism 500 is arranged in the operation unit 30 so as not to obstruct the operation of the left hand of the operator who operates the endoscope 10 and so that the holding mechanism 500 can be operated by the operation of the right hand. It is installed. For example, the holding mechanism 500 is disposed on the same straight line as the distal end portion of the grip portion 33 and the bending operation portion 37.

  As shown in FIGS. 2A, 3B, and 3C, the holding mechanism 500 that is arranged in this way is from the forceps plug portion 36 in which the treatment instrument 400 is arranged in the operation unit 30 of the endoscope 10. A subject is inserted through a treatment instrument insertion port 35a into a treatment instrument insertion channel inside the endoscope 10 and protrudes from a distal end opening 35c disposed at the distal end of the insertion section 20 of the endoscope 10. During the treatment, the guide member 300 that reaches the subject is held as described above in order to guide the treatment tool 400 to the subject. Specifically, as shown in FIG. 2A, the holding mechanism 500 is exposed to the outside of the endoscope 10 from the forceps plug portion 36 so that the guide member 300 is fixed and displacement of the guide member 300 is prevented. The proximal end portion 301 of the guide member 300 is held.

  Therefore, as shown in FIGS. 2A, 2B, and 2C, the holding mechanism 500 includes a holding portion 501 that holds a part 301a of the base end portion 301 of the guide member 300, and a holding portion 501 that holds the holding portion 501. A holding portion 503 that holds another portion 301b of the base end portion 301 of the guide member 300 that is a portion other than the portion 301a. That is, the holding part 501 and the holding part 503 hold different portions of the guide member 300 from each other. In the present embodiment, for example, the part 301a is disposed closer to the distal end side of the guide member 300 than the other part 301b. As described above, the holding unit 501 holds a portion other than the base end portion 301 of the guide member 300 held by the holding unit 503. The holding unit 501 is a separate body from the holding unit 503, and is disposed at a position different from the holding unit 503.

That is, the holding unit 501 is disposed in the operation unit 30 that operates the endoscope 10 and is connected to the proximal end portion of the insertion unit 20. The holding portion 501 is configured such that a part 301a, which is a portion exposed from the endoscope 10 on the proximal end side of the guide member 300 in the state where the distal end portion of the guide member 300 protrudes from the distal end opening portion 35c, by the operation portion 30. keeping.
The holding unit 503 is disposed at a position different from the holding unit 501 in the operation unit 30. As described above, the holding portion 503 is located at a position different from the portion held by the holding portion 501 on the proximal end side of the guide member 300 and in a direction different from the direction of the holding portion 501, and is different from that of the guide member 300. The part 301b is held. The holding units 501 and 503 are disposed in the operation unit 30. In other words, the operation unit 30 holds different portions on the proximal end side of the guide member 300 at different positions in the operation unit 30 and in different directions.

[Holding unit 501]
As shown in FIGS. 2A, 2B, and 2C, the holding portion 501 is operated so that the holding portion 501 is integrated with the exterior portion of the operation portion 30 of the endoscope 10, for example, the exterior portion of the grip portion 33. The unit 30 is disposed. As shown in FIG. 2A, the holding portion 501 is configured so that the guide member 300 is fixed and the position of the guide member 300 is prevented from being displaced in a state where the tip portion of the guide member 300 protrudes from the tip opening portion 35c. A portion 301a exposed from the forceps plug portion 36 to the outside of the endoscope 10 is held. The holding unit 501 holds the part 301 a so that the part 301 a can be attached to and detached from the operation unit 30. That is, the holding unit 501 can release the holding of the part 301a. In other words, the part 301 a can be detached from the operation unit 30.

  As shown in FIG. 2A, for example, the holding portion 501 is arranged such that the axial direction of a part 301a exposed to the outside of the endoscope 10 is orthogonal to the axial direction (opening direction) of the treatment instrument insertion port portion 35a. In order to hold the part 301a, the holding part 501 is arranged so that the axial direction of the holding part 501 is along the orthogonal direction orthogonal to the axial direction of the treatment instrument insertion port part 35a. For example, the holding unit 501 is disposed on an axis different from the central axis of the treatment instrument insertion port 35a.

  As shown in FIG. 2A, for example, the holding portion 501 is disposed near the treatment instrument insertion port portion 35a. Specifically, the holding portion 501 is disposed between the treatment instrument insertion port portion 35 a and the proximal end portion of the insertion portion 20 in detail in the axial direction of the operation portion 30. ing. The holding unit 501 may be disposed, for example, on the exterior part of the grasping part 33 or the exterior part of the treatment instrument insertion part 35.

[Holding unit 503]
As illustrated in FIG. 2A, the holding unit 503 is disposed at a position different from the holding unit 501. As shown in FIG. 2A, the holding portion 503 is configured so that the guide member 300 is fixed in a state where the distal end portion of the guide member 300 protrudes from the distal end opening portion 35c, and the displacement of the guide member 300 is prevented. Another part 301 b exposed from the forceps plug part 36 to the outside of the endoscope 10 is held in a direction different from the direction of the holding part 501. The direction of the holding unit 501 includes the direction in which the holding unit 501 holds a part 301a. As described above, another part 301 b held by the holding unit 503 is a part other than the part 301 a held by the holding unit 501. The holding unit 503 holds another part 301 b so that the other part 301 b can be attached to and detached from the operation unit 30. That is, the holding unit 503 can release the holding of another part 301b. In other words, another part 301 b can be detached from the operation unit 30.

  As shown in FIG. 2A, for example, the holding portion 503 is disposed away from the treatment instrument insertion portion 35. Specifically, the holding portion 501 is disposed between the holding portion 501 and the proximal end portion of the insertion portion 20, specifically, the proximal end portion of the main body portion 31 in the axial direction of the operation portion 30. . The holding unit 503 is disposed in the operation unit 30 so as to be integrated with an exterior unit of the operation unit 30, for example, an exterior unit of the gripping unit 33.

  Accordingly, the holding unit 503 is disposed at a position different from the holding unit 501 and holds a portion different from the portion held by the holding unit 501. The holding part 503 of the present embodiment holds the base end part 301 of the guide member 300 that has passed through the holding part 501.

  For example, the holding unit 503 holds the other portion 301b so that the axial direction of the other portion 301b exposed to the outside of the endoscope 10 is orthogonal to the axial direction of the grip portion 33 of the operation unit 30. Therefore, the holding portion 503 is disposed so that the axial direction of the holding portion 503 is along the orthogonal direction orthogonal to the axial direction of the grip portion 33. Thereby, the holding | maintenance part 503 will be arrange | positioned so that the axial direction of the holding | maintenance part 503 may follow the direction different from the axial direction of the holding | maintenance part 501, for example. In other words, the holding unit 503 holds the guide member 300 in a different direction from the holding unit 501.

[Example of Configuration of Holding Units 501 and 503]
Since the holding unit 501 and the holding unit 503 have the same configuration, the holding unit 501 will be described.

  As shown in FIGS. 2B and 2C, the holding portion 501 is formed by, for example, a part of the planar exterior portion of the operation portion 30 being recessed toward the inside of the exterior portion, and a portion 301a is engaged. It has a groove portion 501a that can be mated. The groove portion 501a has, for example, a U shape or a concave shape. The inner diameter of the groove portion 501 a is substantially the same as the outer diameter of the guide member 300 so that the groove portion 501 a engages with the guide member 300, and the inner shape of the groove portion 501 a is substantially the same as the outer shape of the guide member 300. For this reason, when the guide member 300 is engaged with the groove portion 501 a, the holding portion 501 holds the guide member 300, and the holding portion 501 fixes the base end portion 301 of the guide member 300 to the operation portion 30. In addition, the groove part in the holding | maintenance part 503 is called the groove part 503a. Note that at least one of the holding portion 501 and the holding portion 503 may have a groove.

[Action]
For example, when a subject such as the bile duct 101 is treated with the treatment tool 400 such as an EST knife, the insertion unit 20 is inserted into the duodenum 100 as shown in FIG. 3A. Next, the contrast tube 600 is inserted into the bile duct 101 from the forceps plug 36 through the treatment instrument insertion port 35a, the treatment instrument insertion channel, the treatment instrument raising base 51, and the distal end opening 35c. Then, the contrast agent is injected into the bile duct 101 through the contrast tube 600.

Next, the guide member 300 is inserted into the treatment instrument insertion channel from the forceps plug portion 36 via the treatment instrument insertion port 35a. And as shown to FIG. 3B, the front-end | tip part of the guide member 300 penetrates the treatment tool penetration channel, and protrudes from the front-end | tip opening part 35c. Since the distal end opening portion 35 c is disposed on the side surface, the distal end portion of the guide member 300 protrudes to the side of the distal end portion of the insertion portion 20. Then, the distal end portion of the guide member 300 reaches a subject such as the bile duct 101. As shown in FIG. 2A, the base end portion 301 of the guide member 300 is exposed to the outside of the endoscope 10 from the forceps plug portion 36. Then, the contrast tube 600 is pulled out.
In the above description, the guide member 300 is inserted by the operation of the operator's right hand in a state where the grip portion 33 is gripped by the operator's left hand. The contrast tube 600 is pulled out by the operation of the operator's right hand in a state where the grip portion 33 is gripped by the operator's left hand.

Next, as shown in FIGS. 3C and 3D, the treatment instrument 400 moves along the guide member 300 so that the guide member 300 penetrates the tubular member 401 that functions as a monorail portion. At this time, the treatment instrument 400 is guided by the guide member 300 and inserted into the treatment instrument insertion channel from the forceps plug portion 36 via the treatment instrument insertion port 35a. The treatment instrument 400 is guided by the guide member 300, passes through the treatment instrument insertion channel, protrudes laterally from the distal end opening 35c, and reaches the subject.
As described above, the treatment instrument 400 is guided to the subject by the guide member 300.
In the above, the treatment tool 400 is inserted by an operation of the operator's right hand in a state where the grip portion 33 is gripped by the operator's left hand.
Although not shown, the proximal end portion of the treatment instrument 400 is exposed to the outside of the endoscope 10 from the forceps plug portion 36, similarly to the proximal end portion 301 of the guide member 300.

Next, as shown in FIGS. 2A, 2B, and 2C, the holding mechanism 500 holds the base end portion 301 of the guide member 300 at two locations of the holding portions 501 and 503. At this time, after the base end portion 301 of the guide member 300 is extracted from the forceps plug portion 36, it is directed from the forceps plug portion 36 to the holding portion 501 to draw a loop, for example, and further from the holding portion 501 to draw a loop, for example. It goes to the holding part 503. For example, the holding unit 501 first holds a part 301a, and then the holding part 503 holds another part 301b. This order is not particularly limited.
Specifically, the base end portion 301 of the guide member 300 is engaged with the grooves 501a and 503a by the operator's right hand operation in a state where the grip portion 33 is gripped by the operator's left hand. That is, the guide member 300 is attached to the operation unit 30. As a result, the guide member 300 is fixed, and displacement of the guide member 300 is prevented.

In the above description, the guide member 300 is attached to the operation unit 30 via the holding mechanism 500 by the operator's right hand operation in a state where the grasping unit 33 is held by the operator's left hand.
Next, in this state, the treatment tool 400 treats the subject. When the treatment of the treatment tool 400 is completed, the treatment tool 400 is pulled out from the endoscope 10 with the guide member 300 remaining.

  At this time, as described above, the holding mechanism 500 holds the base end portion 301 of the guide member 300 at two locations of the holding portions 501 and 503. The holding portion 501 and the holding portion 503 are disposed at different positions, and hold different portions of the guide member 300. As a result, the guide member 300 is fixed to the operation unit 30 and the displacement of the guide member 300 due to the extraction operation of the treatment instrument 400 is prevented.

  When the treatment tool 400 is pulled out, there is a possibility that the guide member 300 is pulled out by this force. However, in the present embodiment, the holding portion 501 holds the portion 301a, so that the axial direction of the portion 301a is orthogonal to the axial direction of the treatment instrument insertion port portion 35a. For this reason, even if the above-described force is generated, the position of the guide member 300 is prevented from being significantly shifted.

  When the treatment tool 400 is pulled out, the force accompanying the pulling is directed upward from the forceps plug portion 36, that is, toward the operation portion 30. However, in the present embodiment, the holding portions 501 and 503 are disposed below the treatment instrument insertion port portion 35a. Specifically, the holding portion 501 is disposed between the treatment instrument insertion port portion 35 a and the base end portion of the main body portion 31 in the axial direction of the operation portion 30, and the holding portion 503 is held in the axial direction of the operation portion 30. It is disposed between the part 501 and the base end part of the main body part 31. For this reason, even if the above-mentioned force is directed upward, the displacement of the guide member 300 is prevented.

  When the cylindrical member 401 that functions as a monorail part and is thicker than the treatment instrument 400 is extracted from the forceps plug part 36 and reaches the holding part 501, the holding part 501 once releases the holding of the part 301a. Thereby, the cylindrical member 401 can pass through the holding portion 501. When the tubular member 401 passes through the holding portion 501, the holding portion 501 holds the portion 301a again. Next, when the cylindrical member 401 reaches the holding part 503, the holding part 503 once releases the holding of another part 301b. Thereby, the cylindrical member 401 can pass through the holding portion 503. When the tubular member 401 passes through the holding part 503, the holding part 503 holds another part 301b again. As a result, the treatment instrument 400 is pulled out of the endoscope 10 and removed from the guide member 300. In the above description, the guide member 300 is attached to or detached from the operation unit 30 via the holding mechanism 500 by the operation of the operator's right hand in a state where the grasping unit 33 is held by the operator's left hand. The guide member 300 remains in the endoscope 10 and in the body.

  Next, the holding mechanism 500 releases the holding of the base end portion 301 of the guide member 300 at two locations of the holding portions 501 and 503. For example, the holding portion 501 first releases the proximal end portion 301 of the guide member 300, and then the holding portion 503 releases the proximal end portion 301 of the guide member 300. This order is not particularly limited. The guide member 300 is removed from the operation unit 30 by the operation of the operator's right hand in a state where the grasping unit 33 is held by the operator's left hand.

Next, a basket (not shown) is guided by the guide member 300 in the same manner as the treatment instrument 400, and is inserted into the treatment instrument insertion channel from the forceps plug portion 36 via the treatment instrument insertion port 35a. The basket is guided by the guide member 300, passes through the treatment instrument insertion channel, protrudes laterally from the distal end opening 35c, and reaches the subject. As described above, the holding mechanism 500 holds the base end portion 301 of the guide member 300 again at the two portions of the holding portions 501 and 503. The basket collects gallstones and the like. The basket is pulled out of the endoscope 10.
When the basket is removed from the forceps plug portion 36 and discharged to the outside of the endoscope 10, the holding mechanism 500 moves the proximal end portion 301 of the guide member 300 at two locations of the holding portions 501 and 503 as described above. Release hold. Then, the basket is also removed from the guide member 300. Then, the guide member 300 is pulled out from the endoscope 10.

[effect]
In the present embodiment, since the holding mechanism 500 is integrated with the operation unit 30, it is possible to reduce the trouble of attaching the holding mechanism 500 to the operation unit 30. That is, in this embodiment, the trouble of attaching the holding mechanism 500 separate from the operation unit 30 to, for example, the treatment instrument insertion port 35a can be saved. In the present embodiment, since the holding mechanism 500 is integrated with the operation unit 30, the holding mechanism 500 can be made inexpensive.
In the present embodiment, when the treatment instrument 400 is pulled out, the guide member 300 is fixed by the holding mechanism 500, and displacement of the guide member 300 is prevented. Therefore, in the present embodiment, the holding mechanism 500 can reliably prevent the guide member 300 from being displaced. Thereby, in this embodiment, the treatment tool 400 can be reliably guided to the subject by the guide member 300 under any circumstances.

  In particular, the holding mechanism 500 holds the base end portion 301 of the guide member 300 at two locations of the holding portions 501 and 503. The holding part 501 and the holding part 503 are arranged at different positions, hold different parts of the guide member 300 from each other, and hold them in different directions. Thereby, in this embodiment, the guide member 300 can be fixed to the main body part 31, and the position shift of the guide member 300 accompanying the extraction operation | movement of the treatment tool 400 can be prevented.

  In the present embodiment, when the treatment instrument 400 is pulled out, a force is generated in the axial direction of the treatment instrument insertion port portion 35a. In the present embodiment, the holding unit 501 holds the part 301a, so that the axial direction of the part 301a is orthogonal to the axial direction of the treatment instrument insertion port part 35a. For this reason, even if the above-described force is generated, the position of the guide member 300 can be prevented from being significantly shifted.

  In the present embodiment, when the treatment tool 400 is pulled out, the force accompanying the pulling is directed upward from the forceps plug portion 36, that is, toward the operation unit 30. However, in the present embodiment, the holding portions 501 and 503 are disposed below the treatment instrument insertion port portion 35a. Specifically, the holding portion 501 is disposed between the treatment instrument insertion port portion 35 a and the base end portion of the main body portion 31 in the axial direction of the operation portion 30, and the holding portion 503 is held in the axial direction of the operation portion 30. It is disposed between the part 501 and the base end part of the main body part 31. For this reason, in this embodiment, even if the above-mentioned force goes upwards, the position shift of the guide member 300 can be prevented.

  In the present embodiment, the holding mechanism 500 can attach or detach the base end portion 301 of the guide member 300 to the main body 31 by the operation of the operator's right hand in a state where the grip portion 33 is gripped by the operator's left hand. It can arrange | position so that it may become. In this embodiment, the holding mechanism 500 can be prevented from interfering with the operation of the left hand of the operator who operates the endoscope 10.

  In the present embodiment, since the holding portions 501 and 503 have the groove portions 501a and 503a, the base end portion 301 of the guide member 300 can be easily attached to or detached from the main body portion 31.

For example, when a general holding mechanism different from the holding mechanism 500 of the present embodiment is built in the hard tip 21 such as the vicinity of the tip opening 35c, the hard tip 21 is thickened. In this case, the holding state of a general holding mechanism cannot be confirmed visually.
It is assumed that a holding portion of a general holding mechanism functions as a groove portion 501 a disposed on the treatment instrument elevator base 51. When the diameter of one guide member 300 is different from the diameter of the other guide member 300 for replacement, there is a possibility that the holding portion cannot reliably hold both. When the distal end portion of the guide member 300 has a tapered shape, there is a possibility that the holding portion cannot reliably hold the guide member 300.
It is assumed that the holding portion functions as a groove portion disposed on the treatment instrument raising base 51. When the treatment instrument 400 is pulled out in a state where the guide member 300 is indwelled, the cylindrical member 401 that functions as a monorail portion needs to pass through a holding portion that functions as a groove. In this case, the holding unit needs to release the holding of the guide member 300, but the guide member 300 may be displaced with the release.
However, in the present embodiment, the above can be solved.

  In this embodiment, since the holding mechanism 500 is exposed to the outside, the holding mechanism 500 can be cleaned together with the endoscope 10.

  In the present embodiment, if the central axis of the holding portion 501 is not arranged substantially coaxially with the central axis of the holding portion 503, the holding portion 503 has the same axial direction as the holding portion 501. You may arrange | position so that the orthogonal direction orthogonal to the axial direction of the treatment tool insertion port part 35a may be met.

That is, at least one of the holding portion 501 and the holding portion 503 holds the guide member in a direction orthogonal to the axial direction of the treatment instrument insertion port portion 35a for inserting the guide member 300 into the endoscope 10. It suffices if it is disposed.
At least one of the holding unit 501 and the holding unit 503 may be disposed in an orthogonal direction in which one axis is orthogonal to the axial direction of the operation unit 30.

  At least one of the holding unit 501 and the holding unit 503 may be disposed in the operation unit 30 so as to be integrated with the exterior unit of the operation unit 30.

  In the present embodiment, the inner diameter of the groove portion 501a is substantially the same as the outer diameter of the guide member 300 so that the groove portion 501a engages with the guide member 300, but it is not necessary to limit to this. For example, the inner diameter of the groove 501 a may be slightly smaller than the outer diameter of the guide member 300 so that the groove 501 a engages with the guide member 300. Thereby, the holding force of the holding | maintenance part 501 can be raised. This also applies to the holding unit 503.

  In the present embodiment, the groove portion 501a of the holding portion 501 is formed by recessing a part of the planar exterior portion of the operation portion 30, but it is not necessary to be limited to this. The groove portion 501a may be formed by recessing a part of the raised portion of the exterior portion. This also applies to the groove 503a. That is, at least one of the holding part 501 and the holding part 503 may have a U-shaped protrusion that protrudes from the outer surface of the operation part 30.

  The groove portion 501a may be covered with a cover member (not shown) in a state where the proximal end portion 301 of the guide member 300 is held. This also applies to the groove 503a.

  In this embodiment, the holding part 501 has the groove part 501a, but it is not necessary to limit to this. For example, as long as the holding part 501 can hold the guide member 300, the holding part 501 may have an insertion hole part through which the guide member 300 can be inserted. This also applies to the holding unit 503.

  In the present embodiment, the endoscope 10 is a side view type, but the endoscope 10 may be a direct view type.

  In the present embodiment, at least one of the holding part 501 and the holding part 503 has an elastic body that holds the guide member 300 so that one of the holding part 501 and the holding part 33 of the operation part 30 is integrated with, for example, the exterior part. May be. In this case, the holding mechanism 500 may be formed by molding (for example, integrally molding) an elastic body such as resin.

[Modification 1]
As shown in FIGS. 4A and 4B, in this modification, the holding portion 503 is disposed on the inner peripheral surface of the forceps plug portion 36 inserted into the treatment instrument insertion port portion 35a. For example, the holding portion 503 is disposed at a position farthest from the central axis of the grip portion 33 on the inner peripheral surface. The holding portion 503 has a groove portion 503b that is disposed along the longitudinal axis direction of the forceps plug portion 36 and that can be engaged with another portion 301b. The groove portion 503 b is tapered from the inner peripheral surface of the forceps plug portion 36 toward the outer peripheral surface of the forceps plug portion 36 in the radial direction of the forceps plug portion 36. The groove portion 503b is thinner than the cylindrical member 401.

  In the present modification, the cylindrical member 401 passes through the holding portion 503 when the treatment tool 400 is extracted. At this time, since the tubular member 401 is thicker than the holding portion 503, the cylindrical member 401 is displaced from the holding portion 503 into the forceps plug portion 36. As a result, the treatment tool 400 is also displaced into the forceps plug portion 36. At the same time, another portion 301 b that passes through the tubular member 401 is also displaced into the forceps plug portion 36. That is, another part 301 b is released from the holding of the holding unit 503 by the extraction operation of the treatment instrument 400.

  For this reason, in this modification, since another part 301b can be removed by extraction operation of the treatment tool 400, the effort of removal can be saved.

[Second Embodiment]
Only points different from the first embodiment will be described below with reference to FIGS. 5A, 5B, and 5C.

[Holding unit 501]
The holding part 501 is disposed between the treatment instrument insertion port part 35 a and the proximal end part of the insertion part 20 in the axial direction of the operation part 30. Specifically, the holding portion 501 is disposed between a holding portion 503 described later and a base end portion of the main body portion 31.

  In order for the holding part 501 to hold the part 301a so that the axial direction of the part 301a exposed to the outside of the endoscope 10 is orthogonal to the axial direction of the grip part 33 of the operation part 30, the holding part 501 Are arranged so that the axial direction of the holding portion 501 is along an orthogonal direction orthogonal to the axial direction of the gripping portion 33 of the operation portion 30.

[Holding unit 503]
The treatment instrument insertion portion 35 has, for example, a planar first facing portion 35e facing the forceps plug portion 36.
The forceps plug portion 36 has, for example, a planar second facing portion 36e that faces the first facing portion 35e.
In a state where the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35 a, the holding portion 503 faces the forceps plug portion 36 and is a flat first opposed portion 35 e disposed in the treatment instrument insertion portion 35. It is arranged.

  The holding | maintenance part 503 has the groove part 503c which another part 301b can engage. When the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35a, the groove portion 503c is recessed in the direction opposite to the arrangement position of the forceps plug portion 36 so that the groove portion 503c is covered by the second facing portion 36e. When the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35a, the groove portion 503c is covered with the second facing portion 36e, thereby forming a holding hole portion 505 for holding another portion 301b.

  The axial direction of the groove part 503c is arrange | positioned along the plane direction of the 1st opposing part 35e, for example. The axial direction of the groove portion 503c is disposed along a direction orthogonal to the axial direction of the treatment instrument insertion port portion 35a. That is, the groove portion 503 c is disposed so as to cross the treatment instrument insertion portion 35 and penetrate the treatment instrument insertion portion 35.

  The inner diameter of the groove 503 c is substantially the same as the outer diameter of the guide member 300 so that the groove 503 c engages with the guide member 300, and the inner shape of the groove 503 c is substantially the same as the outer shape of the guide member 300. Therefore, when the guide member 300 is engaged with the groove portion 503c, the holding portion 503 holds another part 301b, and the holding portion 503 fixes the proximal end portion 301 of the guide member 300 to the treatment instrument insertion port portion 35a. To do. The groove portion 503c has, for example, a U shape or a concave shape.

[Action]
The guide member 300 is inserted into the holding hole 505 after the forceps plug 36 is inserted into the treatment instrument insertion port 35a to form the holding hole 505, or the guide member 300 is engaged with the groove 503c. Later, the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35a, and the holding hole portion 505 is formed.

  Under such circumstances, after the guide member 300 of the present embodiment is extracted from the forceps plug portion 36, it passes from the forceps plug portion 36 to the side of the forceps plug portion 36 so as not to interfere with the operation portion 30, for example. It arrange | positions so that the holding | maintenance hole part 505 may be headed. At this time, the guide member 300 passes from the forceps plug portion 36 to the holding hole portion 505 through the side of the forceps plug portion 36 so as to draw a loop, for example. And the guide member 300 is covered with the forceps plug part 36 with the groove part 503c. Further, after passing through the holding hole 505, the guide member 300 is further held by the holding part 501 from the holding hole 505 toward the holding part 501.

[effect]
In the present embodiment, the guide member 300 can be prevented from being unexpectedly removed by covering the holding portion 503 with the forceps plug portion 36. In the present embodiment, it becomes possible to attach the guide member 300 to the groove portion 503c simultaneously with the attaching operation of the forceps plug portion 36 to the treatment instrument insertion port portion 35a, and the labor of the operation can be reduced.

  In the present embodiment, the holding portion 503 is disposed in the first facing portion 35e, but is not limited thereto. Hereinafter, modifications 1 and 2 will be described.

[Modification 1]
As shown in FIG. 6, in a state where the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35 a, the holding portion 503 faces the treatment instrument insertion portion 35 and is a planar shape disposed on the forceps plug portion 36. The second opposing portion 36e may be disposed.

  The holding | maintenance part 503 has the groove part 503d in which another part 301b can engage. When the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35a, the groove portion 503d is recessed in the direction opposite to the arrangement position of the treatment instrument insertion port portion 35a so that the groove portion 503d is covered by the first facing portion 35e. . When the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35a, the groove portion 503d is covered with the first facing portion 35e, thereby forming a holding hole portion 505 for holding another portion 301b.

  The axial direction of the groove portion 503d is disposed along the planar direction of the second facing portion 36e, for example. The axial direction of the groove portion 503d is disposed along a direction orthogonal to the axial direction of the forceps plug portion 36. In this modification, the forceps plug portion 36 is attached to the treatment instrument insertion port portion 35a so that the guide member 300 passing through the groove portion 503d does not interfere with the grip portion 33. The groove portion 503d has, for example, a U shape or a concave shape.

[Modification 2]
This modification is a combination of the second embodiment and Modification 1 of the second embodiment.
That is, as shown in FIG. 7, in a state where the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35a, the holding portion 503 is disposed in both the first facing portion 35e and the second facing portion 36e. Has been.

  The holding | maintenance part 503 has the groove parts 503c and 503d which can engage another part 301b.

  When the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35a, the groove portion 503c disposed in the first opposing portion 35e as one is a groove portion disposed in the second opposing portion 36e as the other. By facing 503d, a holding hole 505 for holding another part 301b is formed.

[Summary]
In the state in which the forceps plug portion 36 is inserted into the treatment instrument insertion port portion 35a, and the second embodiment, the first modification, and the second modification are combined, the holding portion 503 faces the forceps plug portion 36, and the treatment tool It is disposed on at least one of the first facing portion 35e disposed on the insertion portion 35 and the second facing portion 36e disposed on the forceps plug portion 36 facing the treatment instrument insertion portion 35. It becomes. The holding | maintenance part 503 will have a groove part which another part 301b can engage.

  The present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Further, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment.

Claims (9)

An endoscope guide member that guides a treatment tool is inserted by being inserted into the lumen through an insertion portion of an endoscope that is inserted into the lumen, and protrudes from an opening disposed in the insertion portion. A holding mechanism for the guide member,
In the state where the endoscope is operated and is connected to the proximal end portion of the insertion portion, and the distal end portion of the guide member protrudes from the opening portion, on the proximal end side of the guide member A first holding unit for holding a portion exposed from the endoscope by the operation unit;
The first holding portion is disposed at a position different from the first holding portion in the operation portion and is different from a portion held by the first holding portion on the proximal end side of the guide member. A second holding portion for holding the guide member in an orientation different from the orientation of the portion;
Equipped with,
In at least one of the first holding part and the second holding part, a groove that engages a part of the base end part of the guide member by recessing a part of the exterior part of the operation part. A holding mechanism is formed . At least one of the first holding portion and the second holding portion has the guide member in a direction orthogonal to the axial direction of the insertion port portion for inserting the guide member into the endoscope. The holding mechanism according to claim 1 to hold. The first holding portion includes: the treatment instrument and the guide member and the proximal end of the the instrument inlet portion being disposed in the operation portion insertion portion for insertion into the endoscope in the Between
The holding mechanism according to claim 1, wherein the second holding portion is disposed between the first holding portion and a proximal end portion of the insertion portion. The holding mechanism according to claim 3, wherein at least one axial direction of the first holding portion and the second holding portion is disposed along a direction orthogonal to the axial direction of the operation portion. The groove formed in at least one of the first holding portion and the second holding portion is disposed in the operation portion so as to be integrated with an exterior portion of the operation portion. The holding mechanism as described. In a state in which the forceps plug portion against the treatment instrument and the guide and a member disposed in the operation portion for insertion into the endoscope treatment instrument insertion opening it is attached,
The first holding unit or the second holding unit is
A first facing portion disposed in a portion facing the forceps plug portion in which the treatment instrument insertion port portion is disposed in the operation portion ;
A second facing portion disposed in the forceps plug portion, facing a portion where the treatment instrument insertion port portion is disposed in the operation portion ;
The holding mechanism according to claim 1, wherein the holding mechanism is disposed on at least one of the two. The first holding unit or the second holding unit is
One is arranged in the exterior part of the operation part,
Is disposed on the other inner circumferential surface of the treatment instrument and the guide member and the endoscope the operation forceps plug portion attached to the treatment instrument insertion opening disposed on the portion for insertion into the The holding mechanism according to claim 1 .   An endoscope having the holding mechanism according to claim 1. The endoscope according to claim 8 , wherein the endoscope is a side-view type endoscope in which the opening is disposed on a side surface of a distal end portion of the insertion portion.

Images